Midwifery Rheumatic Heart Disease

Question: Analysis of the information and application to midwifery practice or broader issues. Answer: Definition: Rheumatic heart disease is one of the most common heart diseases observed in the children especially noticed in the developing countries. This disease is associated with rheumatic fever. It is an acute or chronic heart disorder which might be the result of valve damage causing rheumatic fever. The Rheumatic fever is an inflammatory condition that affects the connective tissues linked with the heart, skin and brain. The symptoms of this disease are excessive palpitations of the heart, chest pain, swollen stomach, ankles, or wrists and shortness of breath (Marijon et al., 2012). Causes of the disease: According to Marijon et al. (2012), the cause of rheumatic fever is a group of microorganisms namely group A Streptococcus. This bacterium causes the body to attack its own tissues. Such a reaction causes inflammation throughout the body. The bacteria also cause inflammation in the heart and trigger the auto-immune responses. The acute stage consists of pancarditis which involves inflammation of the pericardium, myocardium, and the epicardium. The chronic stage is manifested by valvular fibrosis. This results in the stenosis or insufficiency. The main cause of the rheumatic heart disease is the body generates antibodies to struggle with the microbe, but in its place, the antibodies hit dissimilar target i.e. the bodys own tissues. The antibodies commence with the joints and frequently shift on to the heart and adjacent tissues.Over time, there is progressive damage (rheumatic heart disease, RHD) that may lead to heart failure, stroke, infection of the valves (infective endocarditis), and death (Irlamet al. 2013) Strategies used: The prevention strategies involved in the nursing profession related to the infection may be continued at a numeral of diverse levels. Primordial and primary prevention aims to end the disease happening in the first set, while the objective of the secondary and tertiary prevention is to edge the progression and decrease the consequences of recognized disease (Singh et al., 2012). Primary preventions The primordial prevention aims to develop risk factors related to the disease in the pool. This involves the prevention of GAS infections by implementing activities and measures that relate to the environmental, social, economic and behavioral conditions that elevate the risk of the infection (Irlam et al. 2013). Secondary preventions Secondary prophylaxis with BPG is recommended for all people with a history of ARF or RHD. Four-weekly BPG is currently the treatment of choice, except in patients considered to be at high risk, for whom three weekly administration is recommended. The benefits of three-weekly BPG injections are offset. Three to four weekly intramuscular injections of benzathine penicillin is the treatment of choice. Oral antibiotics may be more convenient but carry higher rates of relapse by the difficulties of achieving good adherence, even to the standard four-weekly regimen (Irlamet al. 2013). Tertiary prevention The intervention in human beings with Rheumatic Heart Disease to decrease symptoms and disability, and avoid premature death. The tertiary level surgical intervention for one patient is equivalent to the annual running costs for a national RHD control program in Pacific countries with small populations ((Singh et al., 2012). References: Irlam, J., Mayosi, B. M., Engel, M., Gaziano, T. A. (2013). Primary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease With Penicillin in South African Children With Pharyngitis A Cost-Effectiveness Analysis.Circulation: Cardiovascular Quality and Outcomes,6(3), 343-351. Marijon, E., Mirabel, M., Celermajer, D. S., Jouven, X. (2012). Rheumatic heart disease.The Lancet,379(9819), 953-964. Marijon, E., Mirabel, M., Celermajer, D. S., Jouven, X. (2012). Rheumatic heart disease.The Lancet,379(9819), 953-964. Singh, J. A., Furst, D. E., Bharat, A., Curtis, J. R., Kavanaugh, A. F., Kremer, J. M., ... Bridges, S. L. (2012). 2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis.Arthritis care research,64(5), 625-639.

Medical Marijuana Essays (1342 words) - Herbalism, Medicinal Plants

Medical Marijuana One of the most controversial issues in the United States is over medical marijuana. Many experiments test the validity of the drug as a medicine, and results of these experiments receive much praise but also some critique. The DEA and the National Organization for the Reform of Marijuana Laws (NORML) are battling over the issue. The underlying matter that cannot be ignored is that marijuana proves to be a useful medication for many patients, especially those with wasting diseases such as AIDS and cancer. In 1996 California passed Proposition 215, which allowed the use of medical marijuana (4444). Since then, six other states have made medical marijuana legal; Alaska, Arizona, Hawaii, Maine, Oregon, and Washington. Santa Cruz in California has gone even further, allowing the medical use of marijuana with a doctors note certifying that the patient has a condition for which marijuana is considered helpful, including AIDS, cancer, multiple sclerosis, glaucoma, anorexia, chronic pain, arthritis, and spastic diseases (22222). Santa Cruz law allows growing marijuana so it may be sold for the cost of production. This way, medical users do not have to resort to buying at street prices. The government made it a requirement that all medical studies on marijuana be paid for by scarce grant money from the National Institute of Health (NIH). In recent years, scientists have tried to persuade the NIH to grant them money for medical studies on marijuana, only to be turned down. Only three studies have been approved by the NIH. On May 22, 1999 the Clinton Administration loosened that restriction, allowing researchers to buy Government-grown marijuana for their research, as long as they can fund themselves. Chuck Blanchard, who is the chief counsel for McCaffrey (director of the Office of National Drug Control Policy) says, Before, the problem was if you wanted marijuana, you had to not only show that it was high-quality research, you had to show that it was more important than other competing applications for NIH funding. Now, as long as you are willing to show that it is high-quality research and also provide your own funding, you can have access to medical marijuana (666 66). The decision of the Clinton Administration came two months after a government-sponsored study concluded that the active ingredients in marijuana, called cannabinoids, appeared useful for treating pain, nausea, and severe weight loss in AIDS patients (666666). No evidence of marijuana being a gateway drug was found. The study also came up with some surprising results. It found that treating glaucoma through marijuana was not as useful as we thought. The drug does reduce eye pressure, but the effects are short-lived. The same study found that marijuana was effective in relieving muscle spasms due to multiple sclerosis (888888). At the 13th International AIDS Conference on July 13, 2000, Dr. Donald Abrams of the University of California released the results of the $1 million study of marijuana on AIDS patients. Abrams concern was to determine whether the chemical components of marijuana in any way interfered with the bodys ability to break down components of protease inhibitors. Protease inhibitors are relatively new antiviral drugs that help HIV patients retain a healthy immune system. Abram found that there was no interference between marijuana and the protease inhibitors in any of the 62 patients. Also, Abrams experiment found that marijuana increased the appetite of the HIV patients. The patients who smoked marijuana (three times a day for 21 days) gained an average of 7.7 pounds, while patients who took Marinol (pill containing active ingredients of marijuana including THC) gained an average of 7 pounds. After the experiment, Dr. Abrams said, Its exciting. Its historic. It confirms that all the states t hat have allowed patients to use medical marijuana have not made a serious mistake. SABIN Other studies have found that marijuana indeed has medicinal value, as well as some risk. The US National Institutes of Health and an affiliate of the National Academy of Sciences have concluded that the active ingredients in marijuana can ease the pain, nausea, and vomiting of cancer and AIDS. It also is prescribed for certain glaucoma patients (555555). The NIH, the Center for Medicinal Cannabis Research, and San Mateo County will all be sponsoring future

Second Generation Immigrant

Second Generation Immigrant Introduction The socio-political and economic plights of the immigrants have been a subject of social research for a long time; the immigrants are considered the â€Å"lowest† cadre in the social stratum in the United States. Their living conditions reveal an unprecedented poverty. This paper seeks to explore the plight of second generation immigrants as compared to the first generation, and to highlight some of the factors that are contributing to the difference in the social well being between the first generation immigrants and the second generation immigrants, in other words, between parents and their children, who seem to be enjoying a relatively â€Å"higher† position in the society. Such a tendency has been attributed to several factors. According to the US Census Bureau Data (2009), it was realised that the second generation immigrants enjoy more privileges in terms of education and health. They earn more and are better educated as compared to their foreign-born counterparts, which highlights the fact that life conditions have increased from the first to the second order of immigrants.Advertising We will write a custom essay sample on Second Generation Immigrant specifically for you for only $16.05 $11/page Learn More Immigration policy American Immigration Policy, which sets laws and guidelines used for regulatory purposes, in my opinion, is the strongest factor explaining the socio-economic difference of the second generation immigrants. The level of achievement of the second generation immigrants can be attributed to the immigration policies. The American immigration policy stresses out the fact that anyone who is born on the American territory automatically becomes a citizen of the US; the US citizenship comes with numerous other benefits from the government as opposed to non citizens. This scenario would obviously work for the benefit of the child since he would be entitled to a lot of privileges as opposed t o the parents who are not original citizens of the US. Social research shows that the Latino second class citizens have the highest enrolment rates in colleges and high school, which affirms the fact that the set policies play a key role. In the acquisition of their citizenship, the Latinos have continued to excel in their undertaking. According to statistics, it is projected that by 2017, there would have been plenty of multiracial Latinos in every key government position as compared to their present occupation of government positions. Cultural assimilation A conflict of cultures is predominant in the lives of the second generation population. The rate at which they adapt and stabilize themselves within the two different cultures attributes immensely to their relatively high level of success. Those who are able to freely blend and adapt to both cultures are more settled and are considered to be more successful as compared to those who take a lot of time to balance between the two c ultures. Most second generation children are multilingual. Nonetheless, they are subjected to humongous racism and segregation in the society as well, which means that these children become much more sensitive to various social phenomena; this sensitivity leads to an increased self motivation and awareness amongst the second generation, which in turn inflames their desire to achieve success against all odds confronting them. Conclusion The paper has exclusively explored some of the core reasons for a relatively high success of the second generation immigrants in comparison with their parents; it has established why the two mentioned factors have led to high achievement rates in the second generation immigrants and the social issues defining their achievements.Advertising Looking for essay on cultural studies? Let's see if we can help you! Get your first paper with 15% OFF Learn More

Strategic Management and Strategic Competitiveness Essay - 10

Strategic Management and Strategic Competitiveness - Essay Example Globalization is a process of increasing proportion of social, economic and cultural activities across the national borders. There were positive and negative impacts of globalization of Coca-Cola Company. Marketing strategies, technology and product differentiation are some of the factors that supported the rapid growth and development of the company globally. Under marketing strategies, the company used popular catchy jingles, and advertising slogans, which had a great impact to the minds and hearts of the people worldwide (Lopez, 2012). The slogans were meant to influence the consumers in remembering the product. The company also customized the product in order to meet needs of the sole markets. Coca-Cola Company also exercised Packaging differentiation, which also had a great impact into various market segments. The impacts of globalization of Coca-Cola Company also had a negative impact in some countries globally. For example, in India, the problems occurred after the company started to exploit recourses and labor in the country. The lands were to be cleared for the establishment of the factories where a number of people got displaced. The agricultural workers were left without a source of income after their lands grabbed by Coca-Cola Company. Many of the farmers committed suicide because they lacked alternatives of earning a living (Rao & Sivaramakrishna, 2008). After the establishment of the factories, the nightmare did not end because the residents were still hired to work in dangerous assembly lines, which caused physical pain and psychological damage as well. The company did not consider age or gender, but hired anybody. Child labors existed, meaning the some of the children did not attend school, which can lead the future generation of India to remain uneducated, hence low chances of stabilizing India. Some of technological factors that have positive impacts to the company include; efficiency of corporations marketing, advertising and

Time Travel Essay Example | Topics and Well Written Essays - 2500 words

Time Travel - Essay Example And having thought what to do, we can only do it now: while the time for action is future we can only await it, and once it is past it is too late. When it comes to time travel, the perception of difference somewhat diminishes, according to various scientists theories presented in various ways we conclude that most of them agree with the notion that in order to travel back in time one has to travel faster than the speed of light. Only in such condition one can travel in time. Along with the speed of light, there are other three factors that are considered for a person in order to travel. Those factors or four elements on which time travel is based are considered at the very core of science fiction, which are: Foote has his own unique perception according to which traveling whether it be the future or the past is reasonable to justify and can be universally accepted by the judgment that a person is always involved in traveling all the time, every minute and at every second and particularly in his sleep because as we sleep our consciousness takes a several hour-long leap into the future. It is no wonder that this scenario has a respectable, if dateable, past in the literature of science and fiction. But nothing, nothing except dream and memory, stands in relation to travel to the past as sleep does to travel to the future. Travel to the past takes all customary notions of cause and effect, as Foote believes in the laws of thermodynamics. (Foote, 1991, p. 9) which suggests, "heat is a form of energy that is in motion". Let us examine this quotation what Foote has said. Heat is a form of energy and so is the man. A living energy in the form of meat and flesh. A man if moves in motion obviously generates and radiates energy and if a man travels faster than the speed of a light it is for sure that he would wake up in an environment which is quite old and ancient for him. Faster than light travel No doubt Foote has related human capabilities with those of the speed of light. Here is the theory presented by Foote based upon FTL travel first: it is true that the physicists of the tribe have devised a mathematical fiction called the tachyon, which, if it exists, must travel faster than light. Greatly simplified, the logic runs like this: in the universe we observe, we postulate the existence of tardyons, particles which must travel more slowly than light, and luminons, which always travel at precisely the speed of light. The more energy one puts behind a tardyon, the faster it travels and the heavier it gets; but as one approaches the speed of light, vast increases in energy are required to accomplish minuscule increases in speed. Only an infinite amount of energy which is not available to us in this universe will suffice to bring a tardyon to the speed of light". (Foote, 1991, p. 9) There is indeed an asymmetry in respect of past and future in the way in which we describe events when we are considering them as standing in causal relations to one another; Macbeath explains this as it reflects an objective asymmetry in nature and thinks that this asymmetry would reveal itself to us even if we were not agents but mere observers. It is indeed true, that our concept of cause is bound up with our concept of intentional action: if an

The idea of play therapy

The idea of play therapy We are never more fully alive, more completely ourselves or more deeply engrossed in anything than when we are playing. -Charles Schaefer Play is the primary way that children learn about the world, understand how different things work, express their thoughts and feelings, develop their physical skills, develop their mental skills, and develop effective social skills and bonds. As children grow, their use of language becomes more sophisticated, but throughout childhood, they usually express much more of themselves in their play. We can understand children better if we understand their play. Rather than engaging in verbal communication, we often learn more about their thoughts, feelings, motivations, and struggles by watching children play. Children more effectively communicate their thoughts and feelings through play than they do through verbal communication. As the child plays, the therapist begins to recognize themes and patterns or ways of using the materials that are important to the child. Over time, the clinician helps the child begin to make meaning out of the play. The Association for Play Therapy (APT) defines play therapy as the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development (www.a4pt.org). Although the idea of play therapy was introduced over 80 years ago, this therapeutic approach has only begun to experience major growth and development within the last 20 years and is still considered to be relatively new in modern therapy practices. Within the past 10 years, play therapy has become more recognized as an effective intervention to reduce challenging behaviors associated with social, emotional, behavioral, and learning difficulties in adults, children and adolescents. While researching this approach, I found it increasingly difficult to find information relative to the proven clinical practice of play therapy as most of the information pertainin g to play therapy still focuses widely on reliability and studies to prove that it is even an effective practice. Because play is so familiar to children, it is a zone of comfort that permits counselors to approach clients in a nonthreatening environment. When children play, they feel safe. They dont respond to simply talking and listening to an adult conversation. Play Therapists use play to help children express feelings about many issues. Children can use play to address feelings about loss and divorce. Children who have been victims of abuse or have experienced a trauma can also benefit. Even a child who is having trouble with peer relations or conduct in school can benefit from play. Children often express their feelings behaviorally and this can be misdiagnosed as ADD/ADHD resulting in these children being medicated unnecessarily. Effects of trauma, loss, and divorce can mimic the symptoms of ADD/ADHD. Instead of using medication as the first option of treatment, children and their therapists can utilize play therapy to work on those feelings. The main goal of play therapy is to eliminate behavioral and emotional difficulties that prohibit a child to function normally, especially in regards to improved communication and understanding between the child and his parents, family, and peers. By using play therapy techniques, the therapist can allow a child or adult to become more aware of their emotions and eliminate any negative behavior that may be a direct result of their emotional and behavioral difficulties. Less obvious goals of play therapy include improved verbal expression, ability for self-observation, improved impulse control, more adaptive ways of coping with anxiety and frustration, and improved capacity to trust and to relate to others. Although play therapy has been proven to be effective for children with various kinds of disorders, it is not as helpful for certain types disorders or illnesses, such as children with the most severe degree of autism and schizophrenia (Landreth, 2002). These two types of children live so exclusively in their own world that t hey cut off interaction with the outside world completely. Because they lack the ability and/or willingness to interact with people and objects, I believe that play therapy might not be the best therapeutic approach for these children. Play Therapy involves the use of role playing, toys, blocks, dolls, puppets, and games to help the child recognize, identify, and verbalize feelings and to communicate what has happened to them and how they feel about these events in their lives. Often, a child will allow a doll or puppet to say things that the child does not feel they are free to tell to anyone. Skilled therapists also use drawing and art work to allow feelings to flow and become expressed. The therapist observes how the child uses play materials and identifies themes or patterns to understand the childs problems. Play therapy is particularly effective with children who cannot, or do not want to talk about their problems. Through a combination of talk and play the child has an opportunity to better understand and manage their conflicts, feelings, and behavior. Sand play therapy is one form of play therapy which allows greater exploration of deep emotional issues. Sand play therapy is suitable for children and adults and allows them to reach a deeper insight and reconciliation of a range of issues in their lives such as internal conflicts that manifest as anxiety and depression, as well as penetrating the depths of personality to experience the self directly. Through a safe and supportive process, clients place miniature figurines in a small sand box to express confusing feelings and inner experiences. This creates a visual representation of the unconscious and reveals concerns that are inaccessible any other way. As materials contained in the unconscious emerge visually and symbolically, it is integrated into a persons sense of self and can be activated to elicit behavioral change. Sand play therapy is an expressive and creative way of working which does not rely on traditional talk therapy. Two major approaches of play therapy are Non-directive (Child-Centered) play therapy and Directive (Cognitive Behavioral Model) play therapy. A skilled practitioner will adopt a mix of both approaches according to each individual child and their circumstances. In non-directive play therapy, the therapist remains supportive, but non-intrusive, and responsibility and direction are left to the child, which emphasizes empowering the client, self-awareness, decision-making, and acceptance of the clients self. In directive play therapy, the therapist aquires responsibility for guidance and interpretation of the therapy by taking an active role in the play and structuring the session for assessment, diagnostic, and treatment purposes. One key concern of non-directive techniques is that young children may not necessarily have the cognitive skills and emotional capacity to repair and master traumatic experiences on their own. Upon researching the information that I found on the different ways to apply play therapy to therapeutic sessions, I personally found directive play therapy to be the most efficient. I like the idea of having more control over sessions and getting the information I need to successfully identify problems and issues for the child. Though both practices use similar ways of play and creative expression for the child, in my opinion directive therapy seems to be the best approach for my own personal counseling style. One issue that comes up most often in regards to the boundaries of play therapy is hugging and/or physical contact. In any therapeutic relationship, it is important for the client to realize that the therapist cares. Therapists accomplish this in traditional talk therapy by attentive listening, reflecting, and empathy with little to no touch involved. This can be quite different when working with children in a play setting. Children can be naturally very impulsive, and may hug the therapist in response to a positive or negative feeling. It is important for the therapist to be aware that hugging and touch are used in many different types of relationships and have a variety of meaning. An ethical response to this issue is to abstain from hugging all clients, especially child clients (McGuire McGuire, 2001). On the other hand, if a therapist is hugged by a child, remaining stiff may send a negative message to the client (Landreth, 1999). Although I found the literature on ethical issue s in play therapy to be lacking, the information I did find was illuminating. It certainly caused me to think more in-depth about the many ethical situations that are specific to working with children and to play therapy. This means being aware of potential ethical issues before they arise and planning in advance on how I would react to those situations. I liked the direction that the literature appears to be heading, which is providing play therapists with more effective and universal guidelines for ethical problem solving. The practice of play therapy requires extensive specialized education, training, and experience. A play therapist is a licensed (or certified) mental health professional who has earned a Masters or Doctorate degree in a mental health field with considerable general clinical experience and supervision (www.a4pt.org). Unfortunately, according Dr. Garry Landreth, who is one of the major key contributors to the field of play therapy, many therapists practicing play therapy do not have the specialized training needed with less than half of the therapists currently practicing play therapy having taken a graduate course in the field. Children are a special client population, and simply having a degree in counseling or another similar field does not qualify a person to provide therapy for them (Corey, Corey, Callanan, 2007). When Dr. Landreth (2001) outlined what play therapy can do for children he also told us what areas of development are often a struggle for children and adults alike. Children start their lives with an amazing skill to play that far too often gets lost in the confusion of the adult world. Many adults still cannot claim responsibility for their actions or to accept themselves for who they are as people. Play, whether with games, puppets, drums, clay, sports, motion, drawing, drama, dolls, sand, or whatever else is available, invites a cascade of positive effects. There are endless possibilities for the use of play therapy with adults (Schaefer, 2003). Play therapy for adults can also allow the bonding with others to form healthy relationships for people who may have experience only with serious dysfunctional interactions. When adults enter into play therapy, they are able to gain access to their inner child. Very often, emotional repression and unhealthy feelings are formed in childhoo d and adults learn to ignore surface exhibition of these emotional traumas. However, with adult play therapy the person has the space to realize and act out those feelings and they can reach a resolution and closure, allowing them to become happier, healthier people. In the limited amount of research that I found on the topic of play therapy, it seems as though there is a lack of consistency among the definitions and its implementation. Some articles and texts clearly defined play therapy; others seemed to distort a traditional definition to fit their purpose. I honestly do not know if there truly is a pure form or definition of play therapy. I did however, through my research, find that the various techniques of play therapy used seemed to be quite effective at helping children to deal with a wide array of issues. In conclusion, I believe that play therapy is a fun, innovative, valid, and effective means of helping clients to express feelings that they have unconsciously repressed or avoided. It can be a very healthy outlet and can be useful at times when traditional talk therapy simply doesnt work. Dr. Landreth (2002) states that play is a childs language and toys are his/her words.

Racquetball :: essays research papers

Racquetball is played by two or four players. When played by two, it is called singles and when played by four, doubles. A non-tournament variation of the game that is played by three players is called cut-throat. Racquetball is a competitive game in which a strung racquet is used to serve and return the ball. The objective is to win each rally by serving or returning the ball so the opponent is unable to keep the ball in play. A rally is over when a player (or team in doubles) is unable to hit the ball before it touches the floor twice, is unable to return the ball in such a manner that it touches the front wall before it touches the floor, or when a hinder is called. Points are scored only by the serving side when it serves an irretrievable serve (an ace) or wins a rally. Losing the serve is called a sideout in singles. In doubles, when the first server loses the serve it is called a handout and when the second server loses the serve it is a sideout. A match is won by the first side winning two games. The first two games of a match are played to 15 points. If each side wins one game, a tiebreaker game is played to 11 points. The specifications for the standard four-wall racquetball court follow. (a) Dimensions. The dimensions shall be 20 feet wide, 40 feet long and 20 feet high, with a back wall at least 12 feet high. All surfaces shall be in play, with the exception of any gallery opening, surfaces designated as out-of-play for a valid reason (such as being of a very different material or not in alignment with the backwall), and designated court hinders. (b) Markings. Racquetball courts shall be marked with lines 1 1/2 inches wide as follows: 1. Short Line. The back edge of the short line is midway between, and is parallel with, the front and back walls. 2. Service Line. The front edge of the service line is parallel with, and five feet in front of, the back edge of the short line. 3. Service Zone. The service zone is the 5' x 20' area bounded by the bottom edges of the side walls and by the outer edges of the short line and the service line. 4. Service Boxes. The service boxes, used in doubles play, are located at each end of the service zone and are designated by lines parallel with the side walls.